Africa

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REPORTER is a feature documentary about Nicholas Kristof, the two-time Pulitzer Prize winning columnist for the New York Times, who almost single-handedly put the crisis in Darfur on the world map. The film puts the viewer in Kristof’s pocket, revealing the man and his methods, and just how and why real reporting is vital to our democracy, our world-awareness, and our capacity to be a force for good. But REPORTER has a second agenda. By tracking a newsman, we track his news.

Pope Benedict XVI said on his way to Africa Tuesday that condoms weren't the answer in the continent's fight against HIV, his first explicit statement on an issue that has divided even clergy working with AIDS patients.

Pope Benedict had never directly addressed condom use. He has said that the Roman Catholic Church is in the forefront of the battle against AIDS. The Vatican encourages sexual abstinence to fight the spread of the disease.

"You can't resolve it with the distribution of condoms," the pope told reporters aboard the Alitalia plane headed to Yaounde, Cameroon, where he will begin a seven-day pilgrimage on the continent. "On the contrary, it increases the problem."

Not surprisingly, Benedict's statements elicited much criticism. It was easy to imagine that the Catholic church's teachings about contraception were dictating his viewpoint rather than a rational assessment of the situation on the ground. Criticism of his statements acknowledged that condoms aren't foolproof and sometimes fail either due to operator error or loss of integrity (link).

Then the official transcript tweaked his words to make it a little less extreme, indicating that condoms risked increasing the problem (link).

Then Edward Green came to the pope's defense. I assume Green's views on this subject are controversial, but he does have some credibility (link):

Edward C. Green is one of the world's leading field researchers on the spread of HIV and public health interventions. He's the director of the Harvard AIDS Prevention Research Project, and is a leading advocate for evidence-based interventions.

I understand Green's point, and I think it's a good one. If condoms are the answer for AIDS in Africa, we should be able to see it in the data. As he said (link):

We have found no consistent associations between condom use and lower HIV-infection rates, which, 25 years into the pandemic, we should be seeing if this intervention was working.

How could condoms contribute to the problem?

...the best evidence we have supports the pope’s comments. He stresses that “condoms have been proven to not be effective at the ‘level of population.’”

“There is,” Green adds, “a consistent association shown by our best studies, including the U.S.-funded ‘Demographic Health Surveys,’ between greater availability and use of condoms and higher (not lower) HIV-infection rates. This may be due in part to a phenomenon known as risk compensation, meaning that when one uses a risk-reduction ‘technology’ such as condoms, one often loses the benefit (reduction in risk) by ‘compensating’ or taking greater chances than one would take without the risk-reduction technology.”

In an interview with Christianity Today (link), Green commented further on what he thinks is and isn't working:

We are seeing HIV decline in eight or nine African countries. In every case, there's been a decrease in the proportion of men and women reporting multiple sexual partners. Ironically, in the first country where we saw this, Uganda, HIV prevalence decline stopped in about 2004, and infection rates appear to be rising again. This appears to be in part because emphasis on interventions that promote monogamy and fidelity has weakened significantly, and earlier behavior changes have eroded. There has been a steady increase in the very behavior that once accounted for rates declining — namely, having multiple and concurrent sex partners. There is a widespread belief that somehow Uganda had fewer condoms. In fact, foreign donors have persuaded Uganda to put even more emphasis on condoms.

I can buy that it's possible that on the level of populations the focus on condom distribution might counter-intuitively fail to reduce the prevalence of AIDS and that this complexity may be underappreciated. Complicated issues are often over-simplified into inaccurate or incomplete sound bites.

On the other hand, I think that the pope's and Green's comments are also an over-simplification because they seem not to acknowledge this fact (as others have pointed out): an African woman for whom monogamous sex with an uninfected spouse is not an option is much safer if her spouse uses a condom. That's the difference between considering the efficacy of condom availability on the individual versus population level. We should be concerned about both.

Part of the issue is also probably that passing out condoms makes someone some cash and is much easier than the hard work of significantly changing a culture's views regarding sexual fidelity. It probably makes sense to start with the easier job...but not just stop there either.

West African amputees got to cheer on their own this week at the first All-African Amputee Football Championship. Thousands of West Africans had their arms or legs hacked off by rebels during Sierra LeoneÂ’s brutal civil war, which drew in militias from neighboring countries and spread across the region before ending in 2002. AngolaÂ’s civil war, which also ended in 2002, left thousands of buried land mines that continue to maim civilians. Amputee soccer teams from Ghana, Sierra Leone, Angola, Liberia, and Nigeria are competing. Each team consists of six one-legged players and a one-armed goalie.

This is a nice story about people who have been devastated by war in Africa finding a way to move on with their lives and not let their injuries be a limitation. I also have to think it would be a curious soccer game to watch.

Mike Cope points to a NY Times article of the same title that tells of the story of what some of his relatives are doing to help improve the lives of children around the world. This is something that's been on my mind a bunch lately. It's hard to imagine any better use of one's time and energy than giving mercy to a child.

On my flight back from Texas today, one of the guys sitting beside me told me that, despite nearing retirement age, he and his wife are in the process of adopting their 5-year-old granddaughter because neither their son nor the girl's mom wanted the responsibility of taking care of a child. This reminded me of my flight from Amsterdam to Detroit last Sunday. I'll write much more about my trip to Belgium/the Netherlands later when I get around to it, but I want to go ahead and tell this story lest I forget to tell it later.

On the flight from Amsterdam, there was a man across the isle to my left who was on his way back from Russia. He and his wife are in the process of adopting two Russian kids (ages 5 and 9, or something like that) and had been there visiting them and taking steps to complete the adoption. In the row in front of me was a dad and his teenage daughter. They were returning form Africa (Zambia?) with a little girl (maybe age 9) whom their family was adopting. The wife and the rest of the kids were going to meet them at the airport in Detroit. I thought it was kind of unusual to be sitting so close to two international adoption stories on that flight.

In Detroit, as I was going through customs, I heard loud clapping and cheering coming from the area where people emerge from customs and greet the public. I quickly looked over, wondering what was happening. I couldn't see much, but I caught a glimpse of the dad who was returning from Africa. I realized that what I had heard and glimpsed was a bunch of people warmly and enthusiastically welcoming to America the little girl from Africa. It was beautiful!

Recently I finished watching Ithuteng, a moving documentary about the Ithuteng Trust School in Soweto, Africa. The school tries to reach troubled kids by, for example, teaching them about the realities of prison and encouraging them to dramatize their own personal stories of trauma (sexual abuse is rampant in South Africa as is AIDS). Unfortunately, the film ends with a disclaimer that it was made prior to allegations about Ithuteng's leader Mama Jackie appearing in the South African press. Apparently she is accused of fabricating stories for the documentary and living in luxury accommodations. Disturbing.

I recently read a couple stories in the NY Times about the tragic plight of kids in Africa.

...part of a vast traffic in children that supports West and Central African fisheries, quarries, cocoa and rice plantations and street markets. The girls are domestic servants, bread bakers, prostitutes. The boys are field workers, cart pushers, scavengers in abandoned gem and gold mines.

By no means is the child trafficking trade uniquely African. Children are forced to race camels in the Middle East, weave carpets in India and fill brothels all over the developing world.

The International Labor Organization, a United Nations agency, estimates that 1.2 million are sold into servitude every year in an illicit trade that generates as much as $10 billion annually.

Studies show they are most vulnerable in Asia, Latin America and Africa.

A 2002 study supervised by the labor organization estimated that nearly 12,000 trafficked children toiled in the cocoa fields of Ivory Coast alone. The children, who had no relatives in the area, cleared fields with machetes, applied pesticides and sliced open cocoa pods for beans.

In an analysis in February, Unicef says child trafficking is growing in West and Central Africa, driven by huge profits and partly controlled by organized networks that transport children both within and between countries.

In a region where nearly two-thirds of the population lives on less than $1 a day, the compensation for the temporary loss of a child keeps the rest of the family from going hungry. Some parents argue that their children are better off learning a trade than starving at home.

Indeed, the notion that children should be in the care of their parents is not a given in much of African society.

Parents frequently hand off children to even distant relatives if it appears they will have a chance at education and more opportunity.

And, so tragic that it's true:

To reduce child trafficking significantly, said Marilyn Amponsah Annan, who is in charge of children's issues for the Ghanaian government, adults must be convinced that children have the right to be educated, to be protected, and to be spared adult burdens â€” in short, the right to a childhood.

Even as this region races to adopt many of the developed world's norms for children, including universal education and limits on child labor, one problem â€” child sexual abuse â€” remains stubbornly resistant to change.

In much of the continent, child advocates say, perpetrators are shielded by the traditionally low status of girls, a lingering view that sexual abuse should be dealt with privately, and justice systems that constitute obstacle courses for victims. Data is sparse and sexual violence is notoriously underreported. But South African police reports give an inkling of the sweep of child victimization. In the 12 months ending in March 2005, the police reported more than 22,000 cases of child rape. In contrast, England and Wales, with nine million more people than South Africa, reported just 13,300 rapes of women and girls in the most recent 12-month period.

Africa is not unique in its high rates of abuse. While a survey of nine countries last year by the World Health Organization found the highest incidence of child sexual abuse in Namibia â€” more than one in five women there reported being sexually abused before age 15 â€” it also found frequent abuse in Peru, Japan and Brazil, among other nations. Relatives are frequent perpetrators in Africa, as in much of the world. But this continent's children face added risks, especially at school. Half of Malawian schoolgirls surveyed in 2006 said male teachers or classmates had touched them in a sexual manner without their permission.

But medical and legal authorities say the vast majority of families still hew to a tradition of accepting payment from perpetrators. The few who press charges are plunged into a criminal justice process that Mr. Mouigni calls deeply frustrating.

Nearly 60% of Ethiopian women were subjected to sexual violence, including marital rape, according to the Ending Violence Against Women report.

Almost half of all Zambian women said they had been attacked by a partner...

In addition to violence from partners, the report also condemned what it found to be high levels of institutionalised violence, such as female genital mutilation, estimating that 130 million girls and women had undergone this practice.

Warning of an imminent bloodbath in the Darfur region of Sudan, tens of thousands of protesters in New York, London, and other cities this week demanded immediate U.N. intervention. Several world leaders joined the call for U.N. action. The Security Council last month agreed to dispatch 22,500 peacekeepers to Darfur, contingent on the permission of the Sudan government in Khartoum. But the government, which has launched a brutal offensive against rebel groups, opposes U.N. involvement...

The U.S. must take the lead, said Sen. John McCain and former Sen. Bob Dole in The Washington Post. We could start by imposing economic sanctions and creating a no-fly zone over Darfur. But we should also make it clear that if these measures fail, military intervention will follow. "The question is whether the United States and other nations will act now to prevent a tragedy, or merely express sorrow and act later to deal with its aftermath."

The article by McCain and Dole in The Washington Post is here. A quote:

The scale of human destruction thus far in Sudan has been staggering. Already, more than 200,000 civilians have been killed, with perhaps 2.5 million forced into squalid camps. This catastrophe is the result of a directed slaughter perpetrated by the Sudanese government and allied Janjaweed militias...

As with Srebrenica in 1995, the potential for further mass killing in Darfur today is plain for all to see. All the warnings have been issued, including one from the United Nations that the coming weeks may see "a man-made catastrophe of an unprecedented scale." What remains unclear is only whether the world has the will to impose an outcome on Sudan different from that which unfolded so tragically in Bosnia. Make no mistake: At some point we will step in to help victims in Darfur and police an eventual settlement. The question is whether the United States and other nations will act now to prevent a tragedy, or merely express sorrow and act later to deal with its aftermath.

I posted previously about Uganda and the LRA here. From an article on bbcnews.com:

Uganda's government has dismissed as "ridiculous" rebel leader Joseph Kony's claims that his Lord's Resistance Army was not involved in atrocities.

International rights group Human Rights Watch expressed surprise at Mr Kony's claim but said he must defend himself at the International Criminal Court.

Thousands have died in a conflict in which the LRA targetted childrenâ€¦

Former BBC correspondent in Uganda, Will Ross, says Joseph Kony may describe himself as a freedom fighter but the LRA has had no clear political agenda and freedom is the last thing that he has brought as his rebels have caused widespread suffering and fear.

The rebels, claiming to be guided by the Bible's Ten Commandments, have caused insecurity in northern Uganda and southern Sudan.

The LRA has kidnapped many thousands of children over the years. It turns the boys into fighters or porters and uses many of the girls as sex slaves.

The world's richest countries are falling short on pledges made last year to provide Africa with life-saving AIDS drugs, expanded trade and increased aid, said rocker-activist Bonoâ€¦

"They started out to climb an Everest but over the past year they got lost at base camp," Bono told Reuters in an interview after the release of a report by his lobby group Debt, AIDS, Trade, Africa group, or DATAâ€¦

The report said wealthy countries had delivered on their promise to cancel the debts of 19 poor countries, most of them in Africa, with 44 countries eligible under World Bank and International Monetary Fund programsâ€¦

The report said relief from burdensome debt payments in Cameroon, Mozambique, Tanzania, Uganda and Zambia has already swelled spending on education, health and AIDSâ€¦

The report said much more was needed to provide access to drug therapy to fight HIV, the virus that causes AIDS.

Globally, AIDS funding has grown to $8.3 billion in 2005 from $300 million in the late 1990's. In Africa, the number of people being treated rose to 800,000 last year from 100,000 in 2003.

DATA said, however, that donors were spending half of what was needed to meet the goal of getting AIDS treatment to at least four million Africans by 2010.

The report commended the United States for leadership on AIDS programs in Africa, and Britain and France for their contributions to a Geneva-based global fund for AIDS.

Canada, Italy, Japan and Germany were laggards, it said.

"Breaking your promise is always bad but breaking a promise to people whose life depends on it is unforgivable," said Bono, who recently traveled to Africa.

The report castigated the G8 for failure to reach a trade deal that would open markets for African products